Evaluates insurance coverage while managing the utilization review process from admission to discharge. Completes and updates medical records pertaining to case management and authorizations. This position participates in a multidisciplinary palliative care team.
Joins with treatment team in reviewing comprehensive patient/ family treatment plan.
Collaborates with physicians and other health care professional regarding patient plan of care and intermediate care goals within proposed time line.
Reviews and evaluates discharge planning on all clients while scheduling follow-up appointments.
Evaluates insurance coverage for optimal use of benefits while managing the utilization process from admission to discharge.
Interviews patient / family members, obtain a complete initial social history including financial information, and communicate with external case managers to receive authorization of payment.
Qualifications Minimum Qualifications:
State of MO RN License.
Associate Degree or Diploma School Program.
1 to 3 years of experience.
BSN and UR, QA, or CM certification.
SSM Health DePaul Hospital is a 476-bed hospital offering comprehensive medical services, including inpatient and outpatient surgeries using state-of-the-art technology and facilities. Opened in 1828, DePaul Hospital - St. Louis was the first hospital west of the Mississippi River and remains the oldest continuously existing business in St. Louis. DePaul Hospital serves patients from across the St. Louis metropolitan area, including the communities of Bridgeton, Florissant, Hazelwood, St. Ann, St. John, Maryland Heights and Overland.
Internal Number: 17011427
About SSM Health
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your family and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same